How Washington is screwing up health care reform – and why it may take a revolt to fix it

By Matt Taibbi for Rolling Stone

Let’s start with the obvious: America has not only the worst but the dumbest health care system in the developed world. It’s become a black leprosy eating away at the American experiment — a bureaucracy so insipid and mean and illogical that even our darkest criminal minds wouldn’t be equal to dreaming it up on purpose.

The system doesn’t work for anyone. It cheats patients and leaves them to die, denies insurance to 47 million Americans, forces hospitals to spend billions haggling over claims, and systematically bleeds and harasses doctors with the specter of catastrophic litigation. Even as a mechanism for delivering bonuses to insurance-company fat cats, it’s a miserable failure: Greedy insurance bosses who spent a generation denying preventive care to patients now see their profits sapped by millions of customers who enter the system only when they’re sick with incurably expensive illnesses.

The cost of all of this to society, in illness and death and lost productivity and a soaring federal deficit and plain old anxiety and anger, is incalculable — and that’s the good news. The bad news is our failed health care system won’t get fixed, because it exists entirely within the confines of yet another failed system: the political entity known as the United States of America.

Just as we have a medical system that is not really designed to care for the sick, we have a government that is not equipped to fix actual crises. What our government is good at is something else entirely: effecting the appearance of action, while leaving the actual reform behind in a diabolical labyrinth of ingenious legislative maneuvers.

Over the course of this summer, those two failed systems have collided in a spectacular crossroads moment in American history. We have an urgent national emergency on the one hand, and on the other, a comfortable majority of ostensibly simpatico Democrats who were elected by an angry population, in large part, specifically to reform health care. When they all sat down in Washington to tackle the problem, it amounted to a referendum on whether or not we actually have a functioning government.

It’s a situation that one would have thought would be sobering enough to snap Congress into real action for once. Instead, they did the exact opposite, doubling down on the same-old, same-old and laboring day and night in the halls of the Capitol to deliver us a tour de force of old thinking and legislative trickery, as if that’s what we really wanted. Almost every single one of the main players — from House Speaker Nancy Pelosi to Blue Dog turncoat Max Baucus — found some unforeseeable, unique-to-them way to fuck this thing up. Even Ted Kennedy, for whom successful health care reform was to be the great vindicating achievement of his career, and Barack Obama, whose entire presidency will likely be judged by this bill, managed to come up small when the lights came on.

We might look back on this summer someday and think of it as the moment when our government lost us for good. It was that bad.

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3 Comments

  1. kevin on September 13, 2009 at 8:57 pm

    “The bad news is our failed health care system won’t get fixed, because it exists entirely within the confines of yet another failed system: the political entity known as the United States of America.”
    Okay, this is a leap–but brand expert John Tantillo writes on Fox Forum, looking at politics from a branding perspective, which i think provides an original and insightful view point. If we accept that entity of the U.S. is a ‘failure’ (author’s assertion), then that is to suggest that proposed health care reform is incompatible with the U.S. “brand” (although that ‘brand’ reality may be to some people’s distaste).
    Tantillo published a post on his marketing blog (separate from Fox Forum) about how the idea of public health insurance doesn’t mesh with the American brand, and is therefore bound to fail. http://blog.marketingdoctor.tv/2009/08/11/john-tantillos-brand-winner-and-loser-pg-and-the-selling-of-health-care.aspx
    I don’t agree..but I do think that to Market the idea of health care reform to the American people, it would also be necessary to Market an idea of the U.S. brand that is consistent with the idea of reform. (ex. rather than criticizing the U.S. gvt as this author does, pointing out the best in American history, pulling out examples of American solidarity, to sell the notion that universal health care is, in fact, All-American.
    Another tactic would be to put front and center the Costs Savings of having a public option. Or to put front and center the idea that With a public option, tax payers would end up contributing Less tax money to uninsured people’s health care, because preventive health care and work done in clinics, out-patient care, etc., rather than done at the ER, would mean Less overall spending. (If you don’t have insurance, you do get care anyway….it’s just more expensive, last-minute, and ends up bankrupting you and/or leaving you with bad credit..and the taxpayers still end up footing the bill.)
    I know that these ideas are being mentioned, but I rarely seem them put First in an appeal to those who (understandably) are concerned with more gvt spending and a loss of personal responsibility and independence in our society. Instead, more typically, the appeal is from a human rights angle. This approach sidesteps the issues of concern to those who are wary of a single-payer or any other gvt program at all, puts them on the defensive by grossly characterizing their position as a monstrous one, and belittles (while perhaps going a ways toward validating) their real concerns and fears.
    The first step to convincing the unconvinced is to understand and respect where they’re coming from.



  2. garyro on September 24, 2009 at 6:01 pm

    Matt does a fine job. Without a single-payer system, reform is doomed to failure.

    The present proposals with or without a public option are too lame to correct many of the problems of our healthcare failure in America.

    We need HR676 and now.



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